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ORIGINAL RESEARCH article

Front. Physiol.
Sec. Respiratory Physiology and Pathophysiology
Volume 15 - 2024 | doi: 10.3389/fphys.2024.1509421

Excess ventilation and chemosensitivity in patients with inefficient ventilation and chronic coronary syndrome or heart failurea case control study

Provisionally accepted
Prisca Eser Prisca Eser 1*Dominic Käsermann Dominic Käsermann 1Pietro Calamai Pietro Calamai 1Kalberer Anja Kalberer Anja 1Laura Stütz Laura Stütz 1Huber Sarina Huber Sarina 1James Duffin James Duffin 2Matthias Wilhelm Matthias Wilhelm 1
  • 1 University Hospital of Bern, Bern, Bern, Switzerland
  • 2 University of Toronto, Toronto, Ontario, Canada

The final, formatted version of the article will be published soon.

    In patients with chronic coronary syndromes (CCS) increased ventilation/carbon dioxide production (V ̇E/V ̇CO 2 ) slope has been found to predict disease progression and mortality similarly to patients with heart failure (HF), however, increased chemosensitivity, a well established predictor for mortality in patients with HF, has rarely been assessed in patients with CCS.Patients with CCS, HF with reduced ejection fraction (EF<50%), old healthy Controls (45+ years) and young Young adult healthy controls (<35 years) were recruited. For patients, a V ̇E/V ̇CO 2 slope ≥36 was an inclusion criterion. The Duffin rebreathing method was used to determine the resting end-expiratory partial pressure of carbon dioxide (P ET CO 2 ), ventilatory recruitment threshold (VRT) and slope (sensitivity) during a hyperoxic (150 mmHg O 2 ) and hypoxic (50 mmHg O 2 ) rebreathing test to determine central and peripheral chemosensitivity.In patients with CCS, HF, and oldControls and young Young controlshealthy, median V ̇E/V ̇CO 2 slopes were 40.2, 41.3, 30.5 and 28.0, respectively. Both patient groups had similarly reduced hyperoxic VRT (at P ET CO 2 42.1 and 43.2 mmHg) compared to 46.0 and 48.8 mmHg in the old Control and young Young controlshealthy. Neither hypoxic VRT nor hyper-or hypoxic slopes were significantly different in patients compared to controlsControls. Both patient groups had lower resting P ET CO 2 than controlsControls, but only patients with HF had increased breathing frequency and rapid shallow breathing at rest.In patients with cardiac diseaseHF and/or CCS and excess ventilation, central chemoreflex VRT was reduced independently of the presence of heart failure. Low VRTs were related to resting excess ventilation in patients with CCS or HF, however, rapid shallow breathing at peak exercise was present only in patients with HF.

    Keywords: Inefficient ventilation, Central chemosensitivity, Cardiopulmonary exercise testing, Resting ventilation, Chronic coronary syndrome

    Received: 10 Oct 2024; Accepted: 31 Dec 2024.

    Copyright: © 2024 Eser, Käsermann, Calamai, Anja, Stütz, Sarina, Duffin and Wilhelm. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

    * Correspondence: Prisca Eser, University Hospital of Bern, Bern, 3010, Bern, Switzerland

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